Interqual Quiz: Test Your IQ! Trivia

1. Expanding and Collapsing Criteria Criteria points may stand alone or be hierarchically embedded in a decision tree. You expand the decision tree by clicking the plus (+) sign to show the underlying criteria points. You collapse the decision tree by clicking the minus (-) sign.

True

False

In decision trees, criteria points can be organized in a hierarchical structure. This means that criteria points can have sub-criteria points nested within them. To view the underlying criteria points, you can expand the decision tree by clicking the plus (+) sign. On the other hand, if you want to hide the sub-criteria points and simplify the view, you can collapse the decision tree by clicking the minus (-) sign. Therefore, the statement "Expanding and collapsing criteria points in a decision tree is possible" is true.

Explanation

In decision trees, criteria points can be organized in a hierarchical structure. This means that criteria points can have sub-criteria points nested within them. To view the underlying criteria points, you can expand the decision tree by clicking the plus (+) sign. On the other hand, if you want to hide the sub-criteria points and simplify the view, you can collapse the decision tree by clicking the minus (-) sign. Therefore, the statement "Expanding and collapsing criteria points in a decision tree is possible" is true.

2. Criteria points are clinical statements that refer to test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies. Criteria points support the reasons or indications; that is, they identify specific clinical elements that must be satisfied to justify the appropriateness of the intervention/service.

True

False

Criteria points are clinical statements that provide specific clinical elements that must be satisfied to justify the appropriateness of the intervention or service. These statements can refer to various aspects such as test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies. By having criteria points, healthcare professionals can ensure that the intervention or service is appropriate and necessary for the patient's condition. Therefore, the statement "Criteria points are clinical statements that refer to test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies" is true.

Explanation

Criteria points are clinical statements that provide specific clinical elements that must be satisfied to justify the appropriateness of the intervention or service. These statements can refer to various aspects such as test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies. By having criteria points, healthcare professionals can ensure that the intervention or service is appropriate and necessary for the patient's condition. Therefore, the statement "Criteria points are clinical statements that refer to test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies" is true.

3. Match the following:

Primary Review

Secondary Review

Submit

4. It is the reviewer's responsibility to choose the correct criteira set for reviewing the request.

True

False

The statement is true because the responsibility of choosing the correct criteria set for reviewing a request lies with the reviewer. The reviewer needs to carefully assess the request and determine the appropriate criteria that should be used to evaluate it. This ensures that the review process is fair, consistent, and aligned with the objectives and requirements of the request. By selecting the correct criteria set, the reviewer can make informed judgments and provide valuable feedback or recommendations on the request.

Explanation

The statement is true because the responsibility of choosing the correct criteria set for reviewing a request lies with the reviewer. The reviewer needs to carefully assess the request and determine the appropriate criteria that should be used to evaluate it. This ensures that the review process is fair, consistent, and aligned with the objectives and requirements of the request. By selecting the correct criteria set, the reviewer can make informed judgments and provide valuable feedback or recommendations on the request.

5. When conducting a review, the reviewer determines an indication for performing a procedure or intervention is not listed. What should the reviewer do?

Deny the request

Use clinical judgement and approve the request

Document the appropriate clinical information and send for secondary medical review

Choose a different indication

When conducting a review, if the reviewer determines that an indication for performing a procedure or intervention is not listed, they should document the appropriate clinical information and send it for a secondary medical review. This is necessary to ensure that all relevant information is considered and to obtain a second opinion from another medical professional. It allows for a more thorough evaluation of the case and helps in making an informed decision regarding the request.

Explanation

When conducting a review, if the reviewer determines that an indication for performing a procedure or intervention is not listed, they should document the appropriate clinical information and send it for a secondary medical review. This is necessary to ensure that all relevant information is considered and to obtain a second opinion from another medical professional. It allows for a more thorough evaluation of the case and helps in making an informed decision regarding the request.

6. In Level of Care Home Care Criteria: When more than 1 service is requested and each will be provider by a different discipline, the reviewer must review each service seperately

True

False

When multiple services are requested in the Level of Care Home Care Criteria and each service will be provided by a different discipline, the reviewer must review each service separately. This means that the reviewer should evaluate each service individually, considering the specific requirements and criteria for that particular service. By doing so, the reviewer can ensure that each service is assessed accurately and appropriately, taking into account the unique aspects and considerations associated with each discipline.

Explanation

When multiple services are requested in the Level of Care Home Care Criteria and each service will be provided by a different discipline, the reviewer must review each service separately. This means that the reviewer should evaluate each service individually, considering the specific requirements and criteria for that particular service. By doing so, the reviewer can ensure that each service is assessed accurately and appropriately, taking into account the unique aspects and considerations associated with each discipline.

7. InterQual Clinical Reference is accessible from the Help menu within IQ View and Review Manager. What materials are available? Choose the correct option:

Review Process-Provides information on criteria components, review process steps, and practical tips

Abbreviations and Symbols- A list of abbreviations and symbols contained in the criteria

Bibliography-includes references used to develop the criteria, lists alphabetically

Drug list-Generic and trade names of some medications that are referenced in the criteria and the notes

Clinical revision-Describe significant change to the clinical content of the criteria, including explanations for the rationale behind the revisions.

All of the above

The InterQual Clinical Reference provides various materials accessible from the Help menu within IQ View and Review Manager. These materials include information on the review process, criteria components, and practical tips. It also includes a list of abbreviations and symbols used in the criteria, a bibliography of references used to develop the criteria, a drug list containing generic and trade names of referenced medications, and clinical revisions that describe significant changes to the criteria's clinical content and provide explanations for the revisions. Therefore, the correct answer is "All of the above."

Explanation

The InterQual Clinical Reference provides various materials accessible from the Help menu within IQ View and Review Manager. These materials include information on the review process, criteria components, and practical tips. It also includes a list of abbreviations and symbols used in the criteria, a bibliography of references used to develop the criteria, a drug list containing generic and trade names of referenced medications, and clinical revisions that describe significant changes to the criteria's clinical content and provide explanations for the revisions. Therefore, the correct answer is "All of the above."

8. To view and print InterQual Criteria, you use Book VIew.

True

False

The explanation for the given correct answer is that to view and print InterQual Criteria, you use Book View. This means that the statement "True" is correct as it accurately reflects the fact that Book View is the tool used for accessing and printing InterQual Criteria.

Explanation

The explanation for the given correct answer is that to view and print InterQual Criteria, you use Book View. This means that the statement "True" is correct as it accurately reflects the fact that Book View is the tool used for accessing and printing InterQual Criteria.

9. Match the number to the choicesfrom the picture below.

1

2

3

4

Submit

10. Which resource provides reminders of best clinical practices, new clinical knowledge, explanations of criteria rationale, definitions of medical terminology, and current literature references.

Clinical Revisions

Inpatient List

Drug List

Information notes located at the end of a criteria point

The information notes located at the end of a criteria point provide reminders of best clinical practices, new clinical knowledge, explanations of criteria rationale, definitions of medical terminology, and current literature references. These notes serve as a valuable resource for healthcare professionals to stay updated on the latest clinical guidelines and evidence-based practices. They help ensure that healthcare providers are making informed decisions and providing high-quality care to their patients.

Explanation

The information notes located at the end of a criteria point provide reminders of best clinical practices, new clinical knowledge, explanations of criteria rationale, definitions of medical terminology, and current literature references. These notes serve as a valuable resource for healthcare professionals to stay updated on the latest clinical guidelines and evidence-based practices. They help ensure that healthcare providers are making informed decisions and providing high-quality care to their patients.

11. What is the primary purpose of InterQual criteria in healthcare?

To determine the best pharmaceutical products for a hospital

To set international qualifications for healthcare professionals

To guide healthcare providers in making evidence-based decisions about patient care

To establish billing protocols for international healthcare services

InterQual criteria are widely used in the healthcare industry to support decision-making on patient admissions, procedures, and treatments. Developed by McKesson, these criteria provide a framework for ensuring that patients receive appropriate care based on the latest evidence and best practices in medicine. InterQual helps healthcare providers determine the necessity and appropriateness of care based on clinical evidence, thereby optimizing patient outcomes and resource utilization. It is not involved with pharmaceutical product selection, setting qualifications for healthcare professionals, nor establishing billing protocols for services.

Explanation

InterQual criteria are widely used in the healthcare industry to support decision-making on patient admissions, procedures, and treatments. Developed by McKesson, these criteria provide a framework for ensuring that patients receive appropriate care based on the latest evidence and best practices in medicine. InterQual helps healthcare providers determine the necessity and appropriateness of care based on clinical evidence, thereby optimizing patient outcomes and resource utilization. It is not involved with pharmaceutical product selection, setting qualifications for healthcare professionals, nor establishing billing protocols for services.

12. Criteria are the clinical information the reviewer should consider when conducting reviews. Criteria are organized in one of the following formats:

Decision Tree

Medical Review

Submit

13. In the Durable Medical Equipment Criteria: When conducting a review, answering questions in a specific pathway will lead the user to Clinical Revisions.

True

False

When conducting a review in the Durable Medical Equipment Criteria, answering questions in a specific pathway will not lead the user to Clinical Revisions.

Explanation

When conducting a review in the Durable Medical Equipment Criteria, answering questions in a specific pathway will not lead the user to Clinical Revisions.

14. Choose the correct order to open the correct Guideline from the question above.

1,2,3,4

2,3,4,1

4,3, 1 or 2

None of the above

The correct order to open the correct guideline is 4, 3, 1 or 2. This means that first, you should open guideline number 4, then guideline number 3, and finally either guideline number 1 or guideline number 2. The order of opening guideline number 1 or 2 is not specified, so either one can be opened after guideline number 3.

Explanation

The correct order to open the correct guideline is 4, 3, 1 or 2. This means that first, you should open guideline number 4, then guideline number 3, and finally either guideline number 1 or guideline number 2. The order of opening guideline number 1 or 2 is not specified, so either one can be opened after guideline number 3.